Related Experiment Video
Updated: May 15, 2026
05:16
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Risk stratification and outcome of patients with hypertrophic cardiomyopathy >=60 years of age
Barry J Maron1, Ethan J Rowin, Susan A Casey
1Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 920 E 28th St, Ste 620, Minneapolis, MN 55407, USA. hcm.maron@mhif.org
Circulation
|January 1, 2013
Summary
Older adults with hypertrophic cardiomyopathy (HCM) face low risks for disease progression or sudden death. Comorbidities, not HCM, significantly impact survival, questioning aggressive defibrillator use in this age group.
Area of Science:
- Cardiology
- Geriatric Medicine
- Genetics
Background:
- Hypertrophic cardiomyopathy (HCM) poses significant sudden death risk, primarily in younger patients.
- Uncertainty exists regarding risks in older HCM patients, complicating defibrillator implantation decisions.
Purpose of the Study:
- To evaluate the risks of sudden death and disease progression in elderly patients with hypertrophic cardiomyopathy.
- To inform clinical decision-making regarding primary prevention of sudden death in advanced-age HCM patients.
Main Methods:
- Retrospective study of 428 consecutive HCM patients aged 60 years or older.
- Follow-up duration of 5.8±4.8 years, assessing mortality causes and clinical events.
- Comparison of all-cause mortality with age-matched US general population data.
Main Results:
- 65% of patients survived to 73±7 years, most with mild symptoms.
- HCM-related mortality was low (3.7%), with only 1.2% experiencing arrhythmic sudden death events.
- All-cause mortality was higher than the general population, driven mainly by non-HCM-related conditions (e.g., noncardiac disease).
Conclusions:
- Elderly HCM patients have a low risk of HCM-related morbidity and mortality, including sudden death.
- Aggressive prophylactic defibrillator implantation is not supported in advanced-age HCM patients.
- Non-HCM related comorbidities significantly influence survival more than HCM in older individuals.
Related Concept Videos
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...